You are a nurse conducting home support visits. You visit David a 46-year-old male with hep C related cirrhosis and HIV related pneumonia once a week. He tells you that you are the only person he ever sees and the treatments make him really sick and depressed most of the time. His house and garden are always untidy and his landlord is threatening him with eviction. He is no longer in contact with any family or friends. What do you do?
Issues for discussion
- Social isolation can have severe effects upon a persons physical and mental health outcomes
- Co-infection with hepatitis C and HIV increases the risk of serious liver disease, which may be due to a reduced immunity allowing hepatitis C to progress more rapidly. HIV infection may increase HCV transmission risk due to a higher viral load. This may impact upon sexual relationships.
Client issues
- Increasing a variety of support services for David is crucial during this time.
- Many AIDS Council programs provide both emotional support programs and home support workers who provide care such as gardening and house cleaning.
- Disability support services may also be able to provide further home support services.
- How can you aid David’s decision by assuring his confidentiality?
Organisational issues
- Can your service allow more time to assist David or support him by a referral process?
- What if David does not agree, or is unwilling to contact support services? How can you gain informed consent to contact a service?